For years, medication abortion ranked far behind surgical abortion in popularity. But now that may be changing, as women increasingly see the pill—legal or not—as a way to get around draconian abortion restrictions.

I’ve been following reproductive rights issues long enough to remember when the drug for medical abortion, RU-486, or mifepristone, was first approved for use by doctors in the United States in 2000. At the time, there was quite a bit of excitement on the pro-choice side and outrage on the anti-choice side over it, in large part because most camps widely believedthat this could create a real revolution in abortion care, making it cheaper and more private. Some pro-choicers hoped it would totally remake abortion care in the United States. Some anti-choicers worried it would make it impossible to know at which clinics they should show up and shame women. The New York Timeseven called medication abortion the “little white bombshell” that was a hassle-free, protester-free “shape of abortion to come.”

What actually happened was… not much. Women did start to use medication abortion—which generally involves taking RU-486 in conjunction with misoprostol—and this helped push the average gestational age of a pregnancy at time of abortion even earlier. Overall, though, the revolution wasn’t much of one. There’s been a slow uptick in the percentage of medication abortions every year. Still, they comprise less than a quarter of non-hospital abortions performed annually, according to the Guttmacher Institute. More distressingly, the availability of medication abortion didn’t do as much as hoped to dissuade protesters or make the experience more private. It did lower the cost somewhat, but abortion regulations—and a generally abortion-hostile culture—meant it was mostly available in the same clinics performing surgical abortions, and patients still had to go through the protester gauntlet in order to get it.

But now, 15 years after the FDA approved RU-486, the “little white bombshell” is legitimately becoming a cultural phenomenon worthy of the name, and it’s due in large part to pressure exerted by anti-choice forces. The privacy it offers, it appears, doesn’t make that much of a difference when abortion is legal and easy to get. But once legal abortion starts being snuffed out, the availability of a small, private pill—whether it’s mifepristone, misoprostol, or a combination of the two—becomes a way for desperate women with little access to take control over their own lives. No one wanted it to happen this way, but thanks to anti-choicers and their restrictions, the abortion pill revolution is under way.

Leave it to Women on Waves to plan a stunt showing how true this is. The organization, which made its name by offering women in countries where abortion is illegal an opportunity to climb on a boat and get it done in international waters, has now announced a plan to fly some drones into Poland and drop abortion pills into the arms of women who need them. Poland has a broad ban, with very few exceptions, on doctors performing abortion. However, according to Women on Waves’ Rebecca Gomperts, it’s not technically illegal for women to self-induce abortion—so the women who take the pills shouldn’t be in any legal danger.

But even so, that’s the genius of the little white bombshell: Who can know who has taken it and who has not? There isn’t a blood test to determine if someone has taken abortion pills. As Women on Web, a sister organization to Women on Waves that helps send abortion pills to women through the mail, explains, the symptoms of a naturally occurring miscarriage and an abortion are exactly the same. If the medication is taken as the World Health Organization guidelines advise, there’s just no way to know.

The fact that abortion pills are easy to hide from authorities was never intended to be their main selling point, but anti-choice efforts have made the current situation inevitable. It certainly proves that pro-choicers were always right: If you take legal abortion away, it doesn’t make women embrace their unwanted pregnancies with open arms, as anti-choicers like to imagine happens. It often means they start resorting to quasi-legal or outright illegal methods in order to get the abortions they need.

So, congrats, anti-choicers. Your pressure has helped the abortion pill become the first thing women in many parts of the world think of when they want to terminate a pregnancy. In El Salvador, the illegal use of a form of the abortion pill has been credited, by Sofia Villalta Delgado of the Salvadoran Ministry of Health, with improving women’s health outcomes in the country by dramatically reducing the number of women who turn up in emergency rooms with sepsis from botched abortions. It’s hard to get numbers, but throughout much of Central and South America in countries where abortion is restricted, the use of the pill has become common knowledge. In Mexico, pharmacies sell a version of the pill, even though abortion is illegal in most of the country, under euphemistic language about bringing back your period.

“Worldwide, medication abortion (a technique using a combination of the drugs mifespristone and misoprostol, or misoprostol alone) has become more common in both legal and clandestine procedures,” Guttmacher’s fact sheet on abortion explains. “Increased use of medication abortion has likely contributed to declines in the proportion of clandestine abortions that result in severe morbidity and maternal death.”

As I said before, the frequency of medication abortion is slowly growing in the United States. But even though the procedure is supposed to be legal here, it’s increasingly hard to get—meaning that the exact same pressures that make abortion pills popular on the black market in El Salvador and Mexico appear to be making them popular here too. One expert that Guardian writer Jessica Valenti spoke to argued that part of the declining abortion rate in the United States is likely attributable to the growing interest in abortion pills obtained illegally. It’s hard to see how it could be otherwise. Birth rates went down alongside the abortion rate. While the reasons behind that are complex—fertility in general is down, clearly, likely because of improved contraception use—the lack of a corresponding surge in the birth rate where legal abortion is increasingly hard to get suggests at least some women are taking matters into their own hands.

While a trollish part of my personality enjoys watching the women of the world thwart the efforts of the forced birth brigade, overall this trend is not a happy-making one. While there have been efforts to get safe and legal help to women who need the pill as an alternative to a clinic-based abortion, anti-choice legislators shut it down pretty quickly with all sorts of state bans on telemedicine abortions. (Though hooray to the Iowa Supreme Court for protecting the women of your state!) There are, of course, all sorts of very reasonable concerns that women don’t know what kind of pills they’re getting or how to take them, and while Women on Web and other activists are trying to get that information out there, gaps remain.

Just as concerning, the invisibility of the pills themselves cause a problem. Anti-choicers know for a fact that some percentage of women—though who knows how many?—that show up at emergency rooms with incomplete miscarriages took an undetectable abortion pill. Of course they’re going to be interested in digging a few up and making examples out of them, in a futile effort to scare other women off doing it. But since there’s no way to tell, the method for picking whodunit, at least in some places like El Salvador, appears to be by assuming, often without any evidence, that anyone young, poor, or single is a likely candidate and just tossing her in jail.

As the cases of Purvi Patel or Kenlissia Jones demonstrate, anti-choice law enforcement in the United States cannot wait to do the same here. Oh, they’re just dipping their toes in, picking a couple of cases where they can cobble together actual evidence of pill-taking, and going after women whose pregnancies ended fairly late in the process. And, as abortion isn’t technically illegal, they’re having to resort to creative interpretations of the law—such as accusing women of murder—in order to justify these arrests. But it’s not unreasonable to think that the suspicion and efforts to weed out the abortion pill users will increase.

Still, as the effort in Poland suggests, the abortion pill revolution is here. And it’s driven not by pharmaceutical companies, but by women doing what they’ve always done: Taking charge of their fertility in any way they can, and getting creative in the face of opposition.

To be published in the journal Contraception, the research concludes women having second trimester medication abortions face no increased risk of future premature birth, miscarriage, low birth weight, or placental complications when compared to first trimester medication abortions.

A new study has found that women having second trimester medication abortions face no increased risk of future premature birth, miscarriage, low birth weight, or placental complications when compared to first trimester medication abortions. The study, to be published in the journal Contraception, examined the public health records of 88,552 Finnish women who, between 2000 and 2009, became pregnant for the first time, had either first or second trimester medication abortions, and subsequently went on to carry pregnancies to term.

Previous studies have found no increased risk of premature birth, low birth weight, or miscarriage in pregnancies following a first trimester medication abortion, and no increased risks comparing first trimester medication abortion with first trimester surgical abortion.

The new study, entitled Medical Termination of Pregnancy During the Second Versus the First Trimester and Its Effects on Subsequent Pregnancy, and conducted by a team led by Finnish researchers Jaana Mannist, MD, and Maarit Mentula, MD, PhD. is the largest available analysis of such risks. In conducting their analysis, the authors sought to correct for methodological flaws found in some earlier studies, such as failure to distinguish between the method of termination of pregnancy or the gestational age at which the pregnancy was terminated. The researchers concluded that their results suggest that second trimester medication abortion in a first pregnancy is “not associated with altered risks of preterm birth, low birth weight, SGA [smaller-for-gestational age] infants or placental complications in subsequent pregnancy, compared with first trimester.”

“The data,” they continue, “are of value when counseling women undergoing second trimester [abortion]. The question of whether or not MTOP [medical termination of pregnancy] during the second trimester is safer than surgical TOP [termination of pregnancy] in terms of adverse events in the next pregnancy remains to be studied.”

The results of this study directly contradict persistent efforts by some legislators to either ban outright, legislate the administration of, or interfere in the delivery of medication abortion, all in the name of health and safety.

On Tuesday, after answering certified questions from the U.S. Supreme Court, the Oklahoma Supreme Court definitively ruled that the state’s restrictions on medication abortion are unconstitutional.

The ruling came in the case of Cline v. Oklahoma Coalition for Reproductive Justice, a case the Roberts Court has indicated it is interested in taking up. The case challenges a 2011 Oklahoma law that bans the off-label use of the abortion pill RU-486 or any “abortion-inducing drug.” The Center for Reproductive Rights filed a legal challenge to the law in October 2011, which was permanently struck down later by a district court judge. In December 2012, the Oklahoma Supreme Court upheld the lower court’s ruling. Attorneys for the State of Oklahoma then petitioned the U.S. Supreme Court for a review of that ruling.

The Roberts Court agreed to review the case but asked first that the Oklahoma Supreme Court give a definitive ruling about the scope of the law. Specifically, the Supreme Court wanted an answer as to whether the Oklahoma law banned, rather than severely regulated, medication abortion, and whether the law prohibited the use of certain abortion-inducing drugs to treat ectopic pregnancies.

The Oklahoma Supreme Court ruled Tuesday the law does both because it “restricts the long-respected medical discretion of physicians” and therefore effectively bans medication abortions and the non-surgical treatment of women with ectopic pregnancies. To come to this conclusion the Oklahoma Supreme Court looked no further than the language of the statute, holding that a plain reading of the statutory language supports no other conclusion. “The use of misoprostol in the protocol described in the mifepristone FDA-approved label is an off-label use prohibited by the terms of HB 1970, and the use of methotrexate in treating ectopic pregnancies is an off-label use also prohibited by HB 1970. HB 1970 effectively bans all medication abortions,” said the court. “[T]he plain language of the statute and the manner in which HB 1970 restricts the long-respected medical discretion of physicians in the specific context of abortion compels an affirmative answer to both of the questions asked, and a position entirely consistent with our decision to affirm the ruling of the district court.”

Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a statement following the ruling, “Today’s decision from the Oklahoma Supreme Court strongly reaffirms that this blatantly unconstitutional law was designed to not only rob women of the safe, legal, and effective option of medication to end a pregnancy at its earliest stages, but also threaten the health, lives, and future fertility of women suffering from ectopic pregnancies.”

The U.S. Supreme Court will now decide whether it will continue to hear the case in light of the Oklahoma Supreme Court’s ruling.

The lawsuit claims a new law, which changed the definition of "abortion clinic" to include facilities that provide only the abortion pill Mifepristone to terminate a pregnancy, unconstitutionally targets one clinic.

On Thursday, the American Civil Liberties Union, the ACLU of Indiana, and the Planned Parenthood Federation of America filed a lawsuit on behalf of Planned Parenthood of Indiana and Kentucky (PPINK) against the Indiana State Department of Health and the Tippecanoe County Prosecutor in U.S. District Court, challenging a new set of anti-abortion restrictions as unconstitutional.

According to the lawsuit, SEA 371 singles out one particular health center in Lafayette, Indiana, for “a host of unnecessary new restrictions,” making it discriminatory and unconstitutional. Passed in the 2013 legislative session, SEA 371 changed the definition of “abortion clinic” to include facilities that provide only the abortion pill Mifepristone to terminate a pregnancy. Mifepristone is a safe, non-surgical abortion option used during the first nine weeks of pregnancy. Lawmakers also amended state law to require clinics that offer non-surgical abortions to meet the same physical requirements as clinics that provide the surgical procedure. These new regulations will require PPINK to renovate its facility by January 1, 2014, in order to meet surgical standards, such as having separate procedure, recovery, and scrub rooms, even though no surgical procedures are performed there. According to the complaint, the law affects only the Lafayette clinic, and does not apply to private physicians’ offices providing the same procedure.

“This law is clearly part of a coordinated national effort to end access to safe, legal abortion by trying to shut down Planned Parenthood health-care centers, which also provide Pap tests, breast and testicular exams, birth control, and STD testing and treatment,” said Betty Cockrum, CEO of PPINK in a statement.

“These legislative changes specifically targeting Planned Parenthood’s Lafayette health center are not reasonably related to any legitimate purpose,” said Ken Falk, legal director of ACLU of Indiana. “The laws irrationally and invidiously discriminate against Planned Parenthood and pose a significant and unnecessary burden that violates the Constitution’s guarantees of privacy, due process and equal protection.”

PPINK is requesting that the U.S. District Court issue an injunction to stop the state regulations from taking effect.

]]>http://rhrealitycheck.org/article/2013/08/22/planned-parenthood-aclu-sue-to-block-indiana-law-designed-to-close-lafayette-clinic/feed/0Medical Abortion in Britain and Ireland: Let’s Join the 21st Century!http://rhrealitycheck.org/article/2011/02/16/medical-abortion-britain-ireland-let-join-21st-century/?utm_source=rss&utm_medium=rss&utm_campaign=medical-abortion-britain-ireland-let-join-21st-century
http://rhrealitycheck.org/article/2011/02/16/medical-abortion-britain-ireland-let-join-21st-century/#commentsWed, 16 Feb 2011 07:02:51 +0000The abortion pill potentially puts the control over abortion into women’s hands, and a lot of conservative men and women aren’t sure they like that.

]]>Medical abortion – popularly known as the abortion pill – has been in the news almost non-stop for several months now in both Britain and Ireland, though for very different reasons. That’s good news because more women are getting to hear about it. Although the method has been around since the late 1980s, most women didn’t start hearing about it until the last ten years or so. But as it’s become more known, so has controversy begun to brew around it. Why? Because the abortion pill potentially puts the control over abortion into women’s hands, and a lot of conservative men and women aren’t sure they like that.

Medical abortion, when used from the time a woman first misses her period until up to 9 weeks of pregnancy (dated from the first day of the last menstrual period), is more than 95% effective, and the earlier it is used, the closer to 100% effective it is. The method consists of two kinds of medication.

First, mifepristone (one 200mg pill) is taken by mouth, swallowed with some water. Then, misoprostol (four pills of 200mcg each) is used 24–48 hours later. These 4 pills can be inserted high up in the vagina, which a woman can do herself, or a nurse or doctor can do for her. Or, they can be taken buccally, that is, placed inside her mouth, two on the inside of each cheek, where they will slowly start to melt and should remain for up to 30 minutes, and then whatever is left should be swallowed with water. Within 4-5 hours later, the woman will (in almost all cases) have a miscarriage.

Spontaneous miscarriages almost always happen at home; women cope with them. There will be menstruation-like bleeding and fluids, but far heavier than a period, more with every week of pregnancy, often with clots. When the embryo is passed with the bleeding, the bleeding will slowly become lighter. It is likely to continue for several days, or somewhat longer, and then gradually stop. The woman will experience cramps and commonly nausea, and she should take ibuprofen for the pain when the cramping starts and more when needed.

For most women, at this early stage, this will terminate the pregnancy. This method is both safe and, yes, easy. Easy for women, and easy for the health service provider, who in almost all cases only has to give the woman information, give her a choice between this method and an early aspiration abortion, and then give her the pills (and insert them vaginally for her if the woman prefers that). With training, this person can be a family planning nurse, a regular nurse, a midwife, a GP, or if no one else is allowed, a gynaecologist. [1]

Three things may go wrong. First, nothing may happen and the woman will need to take a repeat dose of four more 200mcg misoprostol tablets, or opt for an aspiration abortion. Second, bleeding will start and the embryo will be expelled, but the abortion will be incomplete and treatment will be needed to complete it, again a repeat dose of four more 200mcg misoprostol tablets or aspiration. Third, very very rarely, bleeding will become very heavy and the woman will need immediate medical treatment to stop it.

Because these three things may happen, even though they will not happen for the great majority of women, access to medical treatment is very important. Moreover, access to assurance that everything is going OK is also important for women using this method for the first time. Waiting is involved and women can become nervous, and may want someone to talk to, so an abortion phone line can be an important part of providing this method in a way that meets women’s needs.

However, for the vast majority of women, early medical abortion consists of taking the tablets as prescribed, having a miscarriage, and it’s over.

So what’s going on?

In both the North and South of Ireland, where almost all abortion is illegal, women have been crossing the border and coming to Britain or other European cities for a safe, legal abortion. But that costs a lot of money and many women in Ireland can ill afford it. It may take them precious weeks or even a month or two to raise the cash and arrange the trip and the abortion. And meanwhile their pregnancy is advancing. And since the financial crisis started, more women are reporting difficulties in coming up with the money necessary to access abortion services, according to the Irish Family Planning Association (IFPA).

Women in Ireland have discovered medical abortion, because the women’s grapevine and the internet are more powerful these days than the 19th and 20th century Irish laws prohibiting abortion. Pills can be transported all sorts of ways, including through the post. And clearly that is now happening. The newspapers in Ireland picked up the story recently of a Chinese woman who brought medical abortion pills into Ireland and was selling them over the counter in her supermarket. Shock, horror! How could this be allowed to happen, and she has had to pay a €5,000 fine and €5,500 costs. I hope the pro-choice movement in Ireland is brave enough to come out publicly and support her.

But the fact is that in almost every country in the world across Latin America, Asia and many parts of Africa where abortion is still mostly illegal, medical abortion pills are available in pharmacies, drug shops, and street markets. This is far from an ideal situation, and no one who supports women’s right to a safe, legal abortion thinks it is fine as it is.

For a start, only misoprostol tends to be available on its own, and it is not nearly as effective (even with the optimum dose) as it is when taken in combination with mifepristone. Secondly, women and drug sellers may not know what the correct dosage and procedure to follow are. Thirdly, when things go wrong, women may or may not have access to medical back-up. However, medical abortion is reducing the number of deaths from unsafe abortion in many of these countries, because the method does not kill women in the same way as unsafe, invasive methods, such as putting a twig or a rubber hose up the vagina into the uterus, did.

The use of medical abortion pills in Ireland is also not ideal, though women in Ireland who know enough to have accessed the pills are also very likely to know where to ask for help if needed, and they will get that help. Everyone who is pro-choice would far prefer this situation to be regularised. However, that requires abortion to be made legal and medical abortion pills made available through national drug registration and health service provision. How likely is that, do you think, in the near future?

It is ironic that women can cross the border and leave Ireland for an abortion in Britain, paying anything up to £2000 for the privilege, and do so legally (which it must be added Irish women fought for in the courts up to European level in the late 1980s/early 90s), yet medical abortion pills cannot cross the border into Ireland without the customs seizing them – do they not have anything better to do, like seizing seriously harmful drugs such as heroin? – and the anti-abortion movement making their usual hysterical remarks about the pills being “deadly” and so on and so forth, blah blah blah.

When will these guys get over it? As Agata Chelstowska from Poland says in an article I’m about to publish in RHM: “Is it possible that the purpose of the law is not to reduce the number of abortions, but to serve a purely political role, as a symbolic achievement of the Church and right-wing parties?” Yes, it is!! And the name of that achievement is control over women for its own sake. Unfortunately, women don’t accept that anymore, guys, and medical abortion pills are helping us to bypass all that medieval misogynistic control freakery.

Meanwhile, back in Britain…

Yesterday, in 21st century Britain, where abortion has been legal and available since 1967, you would have thought the “guys” involved had got over this issue and accepted that women need abortions, and always will, and that it is the job of the health service to make them available as early and as safely as possible, based on the best evidence-based practice.

We hear a lot about evidence-based practice today. It’s meant to be what everyone follows because it shows you what is best to do to achieve the ends you want and what can go wrong, so you can avoid it – in lawmaking, in economic policy, in health care. Ha ha. Are you watching the coalition government? Never heard of it. Or rather, mouth the words and then ignore the evidence and do something else.

Yesterday, a High Court judge ruled in a case brought by Bpas[2] that the regulations related to the 1967 Abortion Act, which say that the treatment for abortion must be carried out in hospital premises, would have to be amended to allow women to use the second half of the medical abortion regimen (the misoprostol pills) at home.

At the moment, the procedure is that the woman must take the mifepristone pill in front of the doctor or nurse who hands it to her. Then she can go home and wait and come back 24 or 48 hours later to get the misoprostol pills, which must be inserted in her vagina at the clinic or taken buccally (described above) and then she can either wait 4-5 hours for the abortion to happen in the clinic (if they have the facilties for this) or go straight home again. In some cases, if she goes straight home again, the abortion may happen while she is on her way. This is not best practice, and something that any clinician with a brain would prefer not to see happen.

The judge recommended (and many thanks to him for that, it was the best he could do), based on the substantial evidence provided by Bpas, that the government could amend the regulations, which were written at a time when all abortions were surgical procedures and carrying them out in hospital premises was intended to remove them from the backstreets to make them safe. We have long ago moved on from that, and the regulations need to move on too.

“Bpas is very pleased that the Hon Mr Supperstone J has ruled that Section 1(3A) of the Abortion Act as amended in 1990 enables the Secretary of State to react to “changes in medical science” as it gives him “the power to approve a wider range of place, including potentially the home, and the conditions on which such approval may be given relating to the particular medicine and the manner of its administration or use.” …

Since we brought our case to court, the Royal College of Obstetricians and Gynaecologists has produced new guidelines noting the weight of evidence in support of home-use of misoprostol for abortions up to nine weeks and the importance of giving women choice of method. This new, evidence-based guidance was supported by the Department of Health. Given Health Secretary Andrew Lansley’s commitment to evidence-based medicine, patient choice and the liberation of clinicians, we assume he will wish to employ the powers the ruling highlights rapidly so that doctors may provide women legally accessing early abortion with the best possible care.”

What will Andrew Lansley, the Tory Secretary of State for Health, who is planning to destroy the NHS, do? Hard to tell. He’s behind a radical blueprint to privatise and break up the NHS in England, which those who understand how the health service functions, from the medical professional associations to the editors of the BMJ and Lancet, are sure will cause chaos and destruction and cost £3 billion to implement. Does he also have the courage to amend this out-of-date regulation, to bring it in line with current practice in the USA, Sweden, Norway, France, Switzerland, and elsewhere? Probably not, because the anti-abortion fringe in his own party are likely to want to make mincemeat of him if he tries.

Ironically (and this is looking like the century of irony), in this same week the Roman Catholic Diocese of Phoenix, Arizona in the USA, castigated a Catholic hospital for allowing an abortion that saved a woman’s life.

Welcome to the 21st century.

[1] Why should we believe pain and suffering are good for women? Only misogynists and anti-abortionists think that.

[2] Bpas provide abortions for the NHS and for women not eligible for NHS abortions.

]]>NPR’s Michele Martin provides another window into the manufactured controversy over telemedicine and abortion care in Iowa. On one side of the “debate:” Dr. Vanessa Cullins, Vice President for Medical Affairs, Planned Parenthood Federation of America. On the other? Rep. Steve King of Iowa, the politician with a myopic aim to criminalize access to legal abortion and introduce the K-12 set to his anti-abortion position. Cullins discusses why and how Planned Parenthood of the Heartland in Iowa offers medical abortions – ie, the abortion pill – via video conferencing to women without access to abortion care in Iowa. Rep. King argues against increased access because, well, he’s against legal abortion.

Providing telemedicine abortion care requires a nurse practitioner as well as a physician. The patient, after being given a proper exam by a nurse practitioner, is set up via video conferencing with a physician who is licensed to prescribe mifepristone to induce an early abortion. As is the case with other early abortion care, mifepristone is exceedingly safe and relatively easy to use. In fact, notes Cullins, the complication rate is “less than 1 percent.” Says Cullins:

Medication abortion is highly safe, highly effective. And the woman who is being served is not only being served by the physician, but she’s being served by the nurse practitioner and other staff within the affiliate. She is receiving high quality, expert care. There’s absolutely no evidence that provision of medication abortion through telemedicine is any way dangerous. In fact, the record of Planned Parenthood of Heartland is not only that it is highly safe and effective, but women are highly satisfied with abortion being provided through telemedicine services.

Medication abortion – mifepristone – also has a high success rate. Ninety-seven percent of the time the abortion is completed via the pill alone. In the other 3 percent a woman will need to come in for a surgical abortion procedure.

These “facts” seem not to sway King, however. Not only does he get the name of the medication wrong (“I’m going to have to call it RU-486 because I can’t remember the other name,” he tells Cullins), but he doesn’t even pretend to hide his real opposition to the use of telemedicine to offer medication abortions:

Rep. KING: I believe that life begins at the instant of conception and human life is sacred in all of its forms. I’m addressing the law and I’m addressing, also, FDA regulations at which this method that they are pioneering in Iowa violates Iowa law in my view. Certainly the intent, if not exactly the letter of the law, it’s a means to circumvent it.

The question of federal funding of abortion in the United States is a more relevant one these days, with Rep. Chris Smith’s introduction of the “No Taxpayer Funds for Abortion Act” which seeks to do much more than simply institute a permanent ban on federal funding for abortion. King insists on investigating Planned Parenthood for supposedly funneling federal funds into their telemedicine abortion provision, under the radar, though he has absolutely no evidence that is being done. It’s simply a waste of taxpayer time and money. Even Martin wonders:

And, finally, I did want to ask you about the question of taxpayer funding. Your letter, which you’re circulating to colleagues and which you hope to deliver tomorrow, was addressed to Health and Human Services secretary, Kathleen Sebelius. And last week in an interview with The Hill, she said there is no taxpayer funding for abortion. Do you simply don’t believe her?

That is the question. Do King and Smith and their colleagues simply not believe that Planned Parenthood is not allowed to use federal funding for their abortion care? Or is it a more direct paranoia? As King tells Martin:

When that money goes into an organization like Planned Parenthood, if those dollars don’t directly go to something like this Skype abortion proposal that they have, the technique which is being pioneered in Iowa, if it doesn’t go there, then it goes into another fund that frees up dollars.

This is a witch-hunt. Rep. King believes that abortion should be illegal. Therefore he’s attacking anywhere and everywhere and hoping something will stick.

]]>http://rhrealitycheck.org/article/2011/01/25/telemedicine-abortion-care-kings-witchhunt/feed/1Ireland: Importing and Exporting Abortionhttp://rhrealitycheck.org/article/2010/10/26/ireland-importing-exporting-abortion/?utm_source=rss&utm_medium=rss&utm_campaign=ireland-importing-exporting-abortion
http://rhrealitycheck.org/article/2010/10/26/ireland-importing-exporting-abortion/#commentsTue, 26 Oct 2010 11:55:52 +0000A rise in the number of illegal abortion pills imported into Ireland indicates increasing reliance on DIY abortions by women desperate to terminate a pregnancy but lacking access to services at home and money to travel abroad.

]]>Ireland’s Crisis Pregnancy Agency (now known as the Crisis Pregnancy Programme) published its annual report this past summer stating there had been a decrease in the numbers of Irish women travelling abroad for abortion services. Some 6,673 women gave Irish addresses to abortion clinics in Britain during 2001, and the figure dropped to 4,422 in 2009. At least 12 women leave Ireland every day to seek clandestine abortions. There are no figures available for the amount of women resident in Ireland who give false addresses, or who travel to clinics in the Netherlands or Spain. The anti-choice lobby applauded the decreasing figures and took it as a sign that Irish women were no longer terminating pregnancies.

What the Programme report did not show was the number of women who were forced to carry their unwanted or unintended pregnancies to full term as a result of not having the means to make the expensive journey to travel overseas to access abortion services.

Furthermore, it did not mention anything about the numbers of women who are availing of backstreet abortions in Ireland, or inducing miscarriages at home by ordering the abortion pill on the Internet through Women on Web, or other websites where it is readily available.

Dublin based pro-choice activist group Choice Ireland made a Freedom of Information request to the Irish Medicines Board (responsible for control of medicinal products) regarding the number of seizures. It emerged that 1,216 abortion pills were seized during 2009 alone. These seizures represent 1,216 attempted illegal DIY abortions. Were it not for the actions of the IMB and Customs authorities, there would have been at least two dozen illegal abortions in Ireland every week during 2009. This enforcement may have stopped 1,216 pills getting to the women that ordered them, but it is unlikely that they could have stopped every single order from a website or indeed parcels of the drugs coming in from relatives overseas in states where the drugs are available.

The Irish Medicines Board on becoming aware of the seizure of a package intended for a woman began to send the addressees letters seeking details of where they ordered it with the line “On receipt of your response the Irish Medicines Board will reassess your case. We look forward to your cooperation in this matter.”

Clearly the implication of this letter is that there is a threat of criminal prosecution and sanction as a result of the purchase of the abortion drugs. It is not known how many of the women in crisis pregnancy situations complied with the direction of the IMB out of fear that they would be prosecuted and dragged through the courts. In addition, it is not known how many women were either forced to carry their pregnancies to full term against their wishes or went elsewhere in sheer desperation for backstreet abortion services.

The reality is Irish women who want or need to terminate their pregnancy are faced with the prospect of spending large amounts of money to travel outside of Ireland to do so. Immigrant women in precarious residency situations may be prevented from travelling through fear of not being allowed to re-enter the state. Working class and low-income women, very young women and teenagers will have to scrimp and save the money or borrow from a local criminal money lender to pay for an abortion overseas. Or they will, as at least a thousand women in Ireland did during 2009, purchase an abortifacient on the Internet, which could contain absolutely anything. If women are willing to take the risk of terminating a pregnancy using a pill bought online, there is a significant chance that when this option falls through as Customs have seized their order, that they will turn elsewhere having been forced to do so by a State that refuses to acknowledge their right to choose safe and legal abortion services.

The continuous denial of Irish women having abortions was demonstrated by Irish Attorney General Paul Gallagher, who defended Ireland in the ABC case where three women have brought the State to the European Court claiming their rights have been violated by having to travel overseas to procure terminations. Mr. Gallagher made the pious claim that the protection of the foetus was central to the “profound moral values embedded in Irish society.” Given the statistics of women travelling abroad for abortions, and the number of seizures of abortifacients in Ireland, this claim flies in the face of reality for Irish women. While it might be entrenched in certain sections (such as anti-choice groups and the Church), it is estimated that 137,618 Irish women travelled for abortions between 1980 and 2008 so there is something entirely different embedded in the society these women live in. Clearly they rightly hold the value of women having agency over their own bodies in higher esteem, and the Irish Government is happy to export the problem and force women to travel.

The hypocrisy of making women order pills online or travel for a service, criminalised on this island, is readily accepted by Irish politicians who state that there is no demand for abortion services here. Either they are completely ignorant, or displaying a level of callousness towards women in crisis pregnancies that is truly shocking. More than three women every day intended to induce an abortion during 2009.The reality is illegal abortion is now happening in Ireland, and yet the State ignores this. Sinead Ahern from Choice Ireland said:

These seizures further demonstrate that the issue of abortion has not gone away in Ireland. It is time to face up to the reality that Irish women will go to desperate lengths and take huge risks to end pregnancies they feel they cannot continue. It is time to stop turning our backs on these women.

]]>http://rhrealitycheck.org/article/2010/10/26/ireland-importing-exporting-abortion/feed/4A Pioneering Effort to Increase Rural Women’s Access to Safe Abortion in Iowahttp://rhrealitycheck.org/article/2010/08/23/ppiowas-pioneering-efforts-ensure-rural-access/?utm_source=rss&utm_medium=rss&utm_campaign=ppiowas-pioneering-efforts-ensure-rural-access
http://rhrealitycheck.org/article/2010/08/23/ppiowas-pioneering-efforts-ensure-rural-access/#commentsMon, 23 Aug 2010 06:00:00 +0000Planned Parenthood of the Heartland deserves a medal for seeking to address the geographic (and often economic) disparity in access to abortion in a smart and safe way.

]]>For the past two years, Planned Parenthood of the Heartland has been using video-conferencing and a remote-controlled drawer to dispense abortion pills to women seeking early abortions in Iowa clinics. Operation Rescue is taking aim at the practice, charging that because these medication abortions are not “performed by a physician,” they violate Iowa law.

This claim doesn’t stand up. True, medication abortion straddles the line between procedure and prescription: while the physician only acts insofar as giving a woman two pills, the more significant part of the procedure is the counseling that precedes it. But this is exactly the point: the medication abortion “procedure” requires the counsel and knowledge of a health care provider—and these days, we do not have to be physically present to share knowledge and expertise. The digital age has removed countless barriers to information, particularly geographic barriers. Why shouldn’t digital technology also remove barriers to health care?

People living in rural areas have to work harder to gain access to health care, and this is particularly true of reproductive health services. Women in rural areas are disproportionately affected by the obstructionist anti-choice laws that may seem like “no big deal” to those of us in more fortunate circumstances. A waiting period means two long trips, perhaps in a borrowed car, and two days off from work, or two days hiring babysitters. A teenage girl seeking a judicial bypass to a parental notification law may also have a very long journey ahead of her (and she’ll have to find someone other than her parents to drive). Even barring complications, getting to a reproductive health clinic is no small feat for many women living in rural counties. These clinics tend to be few and far between, with small staffs and thus, most likely, limited hours. And many rural clinics that offer reproductive health care do not provide abortion services. In 1998, the Guttmacher Institute studied women’s health clinics in Washington State and found that of the 31 clinics in the rural areas of the state, only one offered abortion services to those in need.

If the right to have a legal, safe abortion begins to seem, to some women, like a theoretical one, then we have a big problem. Planned Parenthood of the Heartland deserves a medal for seeking to address the geographic (and often economic) disparity in abortion access in a smart and safe way. Telemedicine is already practiced in other ways in this country: a doctor may call in a prescription after only talking to a patient on the phone if a diagnosis is not necessary. And in some states, nurse practitioners, trained in counseling, can dispense the abortion pill. Planned Parenthood’s use of telemedicine acknowledges a key tenet of reproductive choice: that the most substantive and often difficult part of an abortion happens before a woman visits a clinic. We are lucky to be living in a time and place where the abortion procedure, whether surgical or by medication, is uncomplicated and very low-risk. The complicated part is the choice, and for that, a woman doesn’t need a doctor.

]]>Of course the major news of the morning is that Scott Roeder, convicted for the murder of Dr. George Tiller, was given a life sentence with no chance of parole for 50 years — effectively the same as life without parole.

The sentencing hearing was unusually long at over nine hours, fact that reporter Ron Sylvester, tweeting for the Wichita Eagle, pointed out.

A lot of sentencing hearings last an hour. Many less than that. We are on hour 9 on Roeder’s sentencing.

Roeder exhibited no remorse during the sentencing hearing and many times complained to Sedgwick County District Judge Warren Wilbert that since he was not allowed to bring the “evidence” he wanted to trial, so he thought he could bring it to his sentencing hearing. The majority of his evidence was his belief that his actions were justified. CNN reports:

“You have the power to acquit and if you were to obey the higher power, God himself, you would acquit me,” Roeder told the judge, Warren Wilbert, before the sentence was handed down.

After Roeder had spoken for about 40 minutes about what he said was the biblical justification for the killing, Wilbert stopped him. “I’m sorry, I’m not providing you a forum for an all-night dissertation on the political debate on the issue of abortion,” Wilbert said.

During the hearing, Roeder interrupted lawyers and the judge and also spoke for 45 minutes in an attempt to mitigate his sentence. He read for 30 minutes from a book written by a man executed for killing an abortion doctor in Florida and compared his plight to that of Jesus Christ.

“The blood of babies is on your hands, Nola Foulston . . . and Ann Swegle,” Roeder yelled at prosecutors as sheriff’s deputies pushed him out of the courtroom after he was sentenced.

Roeder’s sentence was the maximum allowed under Kansas law.

“This crime was cruel and heinous, not only because it took our husband, father and grandfather, but because it was a hate crime committed against George — against all women and their constitutional rights,” Tiller’s family said through attorney Lee Thompson after the hearing ended.

In Other News

Mississippi will become the second state to put a constitutional amendment on the ballot that would redefine life as starting at conception. The Jackson Clarion Ledger reports:

An anti-abortion initiative that seeks to define a “person” as “every human being from the moment of fertilization, cloning or the equivalent thereof,” will be on the 2011 general election ballot.

Secretary of State Delbert Hosemann said Thursday that his office certified 106,325 signatures – well over the 89,285 required to place the initiative on the ballot.

ACLU Mississippi Executive Director Nsombi Lambright said her group is reviewing the initiative. The ACLU’s position is the issue should not be placed on the ballot because it would interfere with the state’s Bill of Rights, which cannot be altered through the initiative process, she said.

“If passed, this could allow extensive interfering in the doctor-patient relationship,” she said. “This instantly puts the government and law enforcement right in the center of families in Mississippi.”

Lambright said she’s also concerned it could affect life-saving treatments, as well as treatments for infertility and abortion in cases of rape and incest.

Colorado will also have a similar constitutional amendment to redefine life at conception placed on their ballot in 2010.

Schmidt’s claim that abortion causes women to die in childbirth (try to follow that one) is not the only hole in his argument. The headline itself is problematic: “Maternal Death Rate Lowest in Abortion Free Ireland.” Ireland is abortion-free like America is drug-free; criminalization of something for which there is a demand does not eliminate that thing. Women in Ireland have abortions illegally, and many go to England, where abortion is legal. In fact, last December, three Irish women brought suit against Ireland’s abortion law in the European Court of Human Rights, arguing that “being forced to travel abroad for abortions endangered their ‘health and well-being’ as safeguarded by the European Convention on Human Rights.” And while statistics showed a decline in the number of women traveling from Ireland and Northern Ireland to England for an abortion, a women’s health advocate in Northern Ireland pointed out that more and more women buy “early medical abortion products”—presumably the abortion pill—online.

It’s hard to take this Live Action post seriously, and I would like to dismiss anything coming from Lila Rose, that nauseating Planned Parenthood sting operator. But Rose, who struck a decidedly martial tone at the end of her speech at the 2009 Values Voter Summit, should not be dismissed. In the speech, she quoted Patrick Henry thus: “Gentlemen may cry,‘Peace! peace!’ but there can be no peace. The war has already begun! Our brethren are already in the field! Why then do we stand here idle what is it that gentlemen wish? What would they have?”

Gentlemen may cry, "Peace! Peace!" — but there is no peace. The war is actually begun! The next gale that sweeps from the north will bring to our ears the clash of resounding arms! Our brethren are already in the field! Why stand we here idle? What is it that gentlemen wish? What would they have?

Perhaps the part about “resounding arms” was too much even for Rose, speaking, as she was, four months after the shooting of George Tiller. Yes, Lila, the war is actually begun. Are you proud to be a part of that war?